Interventional Spine

Bassem, Georgy, MD

Paper/Non-Mentor

Purpose

Vertebroplasty is a widely used technique to treat painful osteoporotic vertebral compression fractures, however, precise control of cement delivery is necessary to minimize the risk of cement leakage. The study is conducted to assess the clinical feasibility of performing vertebroplasty on osteoportic compression fractures using an ultraviscous cement injected by a hydrolic device, CONFIDENCE Vertebral Augmentation System, to further control cement deposition.

Methods & Materials

A retrospective evaluation of series of 94 consecutively treated patients were identified for the review. There were a total of 163 levels which ranged from T3 to L1 vertebral bodies. The degree of leakage, seen in the post-operative films, was assessed at each treated level using a strict 4-point scale (none, minimal, moderate, severe). The pattern of any observed leakage was also characterized as: discal, venous, paravetebral, or epidural.

Results

Pre-operatively the mean degree of vertebral collapse was 29%. A bi-pedicular approach was used for 82% (133/163) levels and unipedicular in 18% (30/163). There was no leakage in 50%, minimal leakage in 42%, and moderate leakage noted in 8% of cases. Both unipedicular and bi-pedicular approaches showed leaks in 50% of cases. The most frequent pattern of leak was venous indicated in 52% of leaks, the adjacent disc in 46%, and paravertebral in 5%. The pattern of leakage was always limited to one region except in two cases.. There were no symptomatic leaks that required surgical intervention.

Conclusion

Vertebroplasty in osteoporotic fractures using a highly viscus cement that can be safely controled and injected via a hydrolic system can be performed safely without significant complications.